Tuberculosis (TB) is an infection that usually affects the lungs. It can also affect other parts of the body such as the brain and bones. It spreads mainly by breathing in infected particles.

When it is given

This is given when your child is between 10 and 14 years. It is sometimes given to babies shortly after they are born if they are at special risk e.g. if a family member has tuberculosis.

Effectiveness

Although TB is no longer common is this country, there are between 5,000 and 6,000 cases a year.

Side-effects

A small blister or sore appears where the injection is given. This is quite normal. It gradually heals leaving a small scar. The BCG is a tried and trusted vaccine and reactions to it are very rare.

How is it given?

Most children have the BCG injection when they are between 10 and 14. Your child will have a skin test to see if they already have immunity to TB. If not, the immunization is given. Babies under three months who are having the immunization don't need to have the skin test.

This disease begins with a sore throat and can progress rapidly to cause problems with breathing. It can damage the heart and the nervous system (by releasing toxins into the bloodstream) and in severe cases it can kill.

Tetanus

Tetanus spores are found in soil. They enter the body through a cut or burn. Tetanus is a painful disease that affects the muscles and can cause breathing problems. It causes severe muscle rigidity and agonizing contractions. If it is not treated, it can kill. It cannot spread from one person to another.

Whooping cough (pertussis)

Whooping cough can be very distressing. In young children it can last for several weeks. Children become exhausted by long bouts of coughing which often cause vomiting and choking. In severe cases pertussis can kill. There is a very typical whooping noise as the child takes a deep breath. Pertussis can cause pneumonia and vomiting.

HIB (Haemophilus influenzae type b)

Hib is an infection that can cause a number of serious illnesses including blood poisoning, pneumonia and meningitis. All of these diseases can be dangerous if not treated quickly.

The Hib vaccine protects your child against this one specific type of meningitis. The Hib vaccine does not protect against any other type of meningitis. which can dehydrate a small child. It can occasionally cause brain damage. Pertussis is highly infectious.

When it is given?This is given when your child is 2, 3 and 4 months old. Your child will receive a further tetanus and diphtheria booster at age 3-5 and a further one at 13 to 18 years.

EffectivenessDiphtheriaThe number of cases of diphtheria in the UK has dropped dramatically since immunization began. In 1940, there were 46,000 cases (2480 deaths) due to diphtheria in the UK. Between 1986 and 1995 there have been 38 cases and no deaths.

PertussisIn 1975, the vaccination rate was 30% in England and Wales. Over 10,000 cases were reported. In 1995, the vaccination rate was 94% and 1,873 cases were reported.

HibBefore the Hib vaccine became part of the childhood immunization programme in 1992, over 60 children a year died as a result of Hib infection. And more than twice that number were left with permanent brain damage. Since immunization began, the number of children with Hib meningitis has dropped by more than 95%. Side-effects After the triple vaccine (DTP), your baby may become upset and feel very hot (about 12-24 hours later).

There may be swelling and redness at the site of injection. Your child may also exhibit signs of tiredness, transient fever or allergic reaction. A lump may develop under the skin where the needle was inserted. It may become slightly raised, hot and red. Sometimes the lump stays for several weeks.

How is it given?Some vaccines stimulate enough antibodies in a single shot. Others need more injections to build up levels gradually. Antibody levels may decline after months or years and so repeat doses are given.

Protects againstThis vaccine gives protection against hepatitis B. There are several different types of hepatitis and they all cause inflammation of the liver. The hepatitis B virus is passed through infected blood and may also be sexually transmitted.Some people carry the virus in their blood without actually having the disease itself. If a pregnant woman is a hepatitis B carrier, or gets the disease during pregnancy, she can pass it on to her child. The child may not be ill but there is a high chance of becoming a carrier and developing liver disease later in life.

When it is givenMany pregnant women are screened for hepatitis B during their antenatal care. If found to have the virus, their babies should receive a course of vaccine to prevent them getting hepatitis B and becoming a carrier. The first dose should be given within two days of birth, and two more doses should be given before the child is six months.

Side-effectsSide effects of the vaccine tend to be quite mild. The injection site is often red and can be sore for a few days afterwards.

Meningitis C - meningococcal group C conjugate vaccine

Protects against Neisseria meningitis group C bacteria

How is it givenMeningitec is given by a doctor or a nurse. The vaccine is a 0.5ml injection which is usually given into the muscle of the thigh in infants and into the shoulder muscle for older children, adolescents and adults.

When it is givenThe usual childhood vaccination schedule consists of three injections of Meningitec starting at 2 months of age with an interval of at least 1 month between doses. For children over the age of 12 months who have not previously been immunized with Meningitec, a single dose (0.5ml) of the vaccine is recommended.

EffectivenessProvides protection for around 20 years.

Side-effectsThe most common side-effects in all ages are: redness, swelling and tenderness/pain at injection site. Common side-effects in infants and toddlers are: fever, crying, irritability, drowsiness, impaired sleeping, loss of appetite, diarrhea and vomiting.

Occasionally but rarely, serious allergic reactions can occur, the symptoms of which include:swelling of the hands, feet, ankles, lips, mouth or throat which may cause difficulty in swallowing or breathing. Sometimes there is also a rash. If these symptoms occur - consult your doctor immediately.

MMR - Measles, Mumps, Rubella vaccine

What is measlesThe measles virus is very infectious. It causes a high fever and a rash. About one in 15 children who gets measles is at risk of complications which may include chest infections, fits and brain damage. In severe cases measles can kill.

What is mumpsThe mumps virus causes swollen glands in the face. Before immunization was introduced, mumps was the commonest cause of viral meningitis in children under 15. It can also cause deafness, and swelling of the testicles in boys and ovaries in girls.

What is rubellaRubella, German measles, is usually very mild and isn't likely to cause your child any problems. However, if a pregnant woman catches it in her early pregnancy (first 8-10 weeks) and sometimes up to 16 weeks, it can harm the unborn baby.

EffectivenessMeasles:Before the vaccine was introduced, about 90 children a year in the UK died from measles. Because of immunization, children no longer die of measles. Before immunization was available, up to 800,000 cases were notified each year inEngland and Wales. By 1993, notifications had fallen to 9,612.

Risks/side-effects of vaccineFirst dose:Rash/fever: Following the first dose of MMR, fever and/or rash may occur, (usually within a week to 10 days after immunization). This will last for a few days at the most.Febrile convulsions: In rare instances febrile convulsions (fits) occur 6-11 days after the MMR is given. This is thought to be due to the measles component. The pattern is identical to that occurring when measles vaccine is given alone. It is worth watching for a fever from day 5-11 and giving paracetamol liquid at the first sign of a temperature.

Second dose:Reactions to the second dose of MMR are much rarer, but the same precautions as for the first dose are recommended. Very rarely, a child will get a mild form of mumps about three weeks after the injection. Your child will not be infectious at this time, so they can mix with other people as normal. The MMR vaccine is prepared in egg but it can be given to children who are allergic to eggs. If your child has had a serious reaction to eating eggs, of food containing egg, then talk to your doctor. The usual signs of a serious allergic reaction are a rash that covers the face and body, a swollen mouth and throat, breathing difficulties and shock. In these cases your doctor can make special arrangements for the immunization to be given safely.

Polio – Poliomyelitis

What does it protect againstPolio vaccine protects against the disease poliomyelitis.

What is polioPolio is a virus that attacks the nervous system and can cause permanent muscle paralysis. It tends to multiply in the motor nerves (those that cause the muscles to contract). It can cause permanent paralysis of the affected muscles. If it affects the chest muscles it can kill. The vaccine given nowadays is a modified form of the livevirus. It is extremely safe and effective.

When it is givenThis is given when your child is 2, 3 and 4 months. The first booster is given when your child is between 3 and 5 years. The second booster is given when your child is between 13 and 18.

How is it givenUnlike other immunizations, you take the polio vaccine by swallowing it. The doctor or nurse drops the liquid into your child's mouth.

EffectivenessIn 1955, 4000 cases of polio were reported in England and Wales. Between 1985 and 1995 only 28 cases were reported. In 1996, 96% of all children were immunized.

Side-effectsThere is an extremely small chance of developing polio from the immunization - the risk is of one case in more than 1.5 million doses used. There is also a risk to those who are in close contact with the child receiving immunization, e.g. parents, grandparents and care givers. Close contacts should make sure that they are up-to date on their own immunizations.